Intern Med . Severe Coronavirus Disease 2019 that Recovered from Respiratory Failure by Treatment that Included High-dose Intravenous Immunoglobulin

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Intern Med


. 2020 Dec 15.
doi: 10.2169/internalmedicine.6326-20. Online ahead of print.
Severe Coronavirus Disease 2019 that Recovered from Respiratory Failure by Treatment that Included High-dose Intravenous Immunoglobulin


Yasuhito Suzuki ¹ , Yoshinori Tanino ¹ , Takefumi Nikaido ¹ , Hiroyuki Minemura ¹ , Takashi Umeda ¹ , Mami Rikimaru ¹ , Takumi Onuma ¹ , Shotaro Naito ² , Yoshinori Takiguchi ³ , Hikaru Tomita ¹ , Takaya Kawamata ¹ , Ryuichi Togawa ¹ , Yuki Sato ¹ , Manabu Uematsu ¹ , Julia Morimoto ¹ , Kadzuhiro Kitakawa ⁴ , Yasuhiko Tsukada ⁵ , Kiwamu Nakamura ⁶ , Keiji Kanemitsu ⁶ , Ken Iseki ⁵ , Yoko Shibata ¹



Affiliations

• PMID: 33328409
• DOI: 10.2169/internalmedicine.6326-20

Abstract

We herein report a case of severe coronavirus disease 2019 (COVID-19) in which high-dose intravenous immunoglobulin (IVIg) treatment achieved significant clinical improvement of deterioration of pulmonary inflammation after temporary clinical improvement. In the present case, clinical and radiological deterioration occurred despite a decrease in viral load, suggesting that deterioration was caused by reactivation of proinflammatory factors, such as tumor necrosis factor-α and interleukin-6, rather than direct viral effects. IVIg treatment may provide not only immunosuppressive effects but also inhibition of proinflammatory cytokines, indicating that treatment including IVIg may be effective by inhibiting cytokine storm in SARS-CoV-2 infection.

Keywords: COVID-19; acute respiratory distress syndrome; deterioration; intravenous immunoglobulin; severe acute respiratory syndrome-coronavirus-2.